Most private medical labs ‘misdiagnose’ illnesses

KABUL (Pajhwok): Despite spending hundreds of millions of dollars on Afghanistan’s private health sector during the past one and a half decades, the country’s citizens continue to face many issues when it comes to diagnosing a disease.

Many citizens complain about wrong diagnoses of diseases at local private laboratories, something that compels Afghan patients to visit neighboring or regional countries for having a reliable and accurate detection of their illness.

Studies show the Afghans annually spent about $300 million on their treatment abroad due to low quality health services and lack of standard hospitals inside the country.

Residents say local medical laboratories lack advanced equipment and professional individuals and thus diseases are not correctly recognized.

A resident of Kabul City, Haji Rahimshah, told Pajhwok Afghan News he recently visited a medical lab in Khairkhana neighborhood for a blood cholesterol level test. He said his test results showed the cholesterol level at 154 (mg/dl.)

“but I went to another lab one hour after the first test. There my cholesterol level was shown 220.”

Another resident of Kabul City, Zamari, said unprofessional individuals run medical laboratories amid a lack of proper environment.

Zamari visited a lab in Kart-i-Parwan area to know his blood group and after the test, he was told his blood group name ‘BRH.’

“After a month, I had to give blood to my ailing sister at Rabia Balkhi Maternity Hospital, where I tested my blood group again and they said it was ‘AB Rh D positive.’

Then to confirm it, Zamari went to the 400-bed Sardar Mohammad Daud Khan Hospital, where his blood group was tested ‘AB Rh D positive.’

“This unprofessional behavior could have led to the loss of my sister because I considered his blood to be ‘BRH’ based on the first test.”

Another Kabul inhabitant, Jamila, said she had been suffering from severe body ache and swelling of fingers and toes and a doctor prescribed her a rheumatism test.

“But I was tested negative for the illness at a lab near Baharistan Cinema and the doctor gave me medicines based on the diagnosis, however, I did not recover.”

Due to no impact of the medicines, she went to another lab where her rheumatoid factor was tested above 400. “So when I used medicines for the correct test, my sickness was treated.”

Another resident, Qiyamuddin, who had suffered from the consequences of a wrong diagnosis, asked the Ministry of Public Health (MoPH) to increase its monitoring on local labs.

He said a huge amount of money was annually spent by the Afghans on their treatment abroad and this issue should be paid a serious heed.

Doctors at laboratories and diagnosis centers also acknowledge complaints about misdiagnosing and cite many reasons behind the problem.

An official at the ‘City Laboratory, Dr. Farid Ahmad Ahmadzai, said the MoPH didn’t monitor most of the private labs.

He said another problem was unfamiliarity of a number of Afghan doctors with new and advanced lab machines.

Machinery used at many labs in Afghanistan were imported from abroad despite the lack of technical personnel to teach doctors how to use the machines, he added.

Ahmadzai blamed private universities and institutes for the issues in labs, saying these organizations issued degrees to students blindly and without merit. “When the ignorant graduates don’t know about labs and technology, how can you expect accurate diagnosis from them?”

“A 10 to 30 percent difference in a test result is normal, but above that is worrisome.”

He said the health ministry had failed to properly oversee and investigate private labs’ functioning.

He said a low quality ‘reagent’ (A chemical substance used to create a reaction in combination with some other substance) was used at local labs, which had a bad effect on the diagnoses.

Wahaj cited recruitment of unprofessional people and functioning on other individuals’ licenses as other main issues, asking the MoPH to prevent the phenomenon.

He said large and prominent medical laboratories had established small agencies which lacked modern machinery and professional workforce.

He alleged 30 to 50 percent of labs offered a specific amount of commission to doctors for referring patients to them.

A representative from Herat at the Wolesi Jirga and health panel in-charge at the house, Dr. Saleh Mohammad Saljoqi, claimed they had many times summoned MoPH officials over the issues and concerns about labs.

The lawmaker confirmed complaints regarding laboratories had increased, blaming both the labs and the MoPH for the situation.

A law governing the private health sector had been passed, he said, adding if the law wasn’t being implemented, then the problem lied in the MoPH itself.

He said the lack of scientific cadres, specialists and technologists had eroded people’s trust in the private health sector.

The Afghanistan Chamber of Commerce and Industries (ACCI) said the Afghans spent a huge capital on their treatment abroad due to the shortage of standardi health services in the country.

He said the private sector health institutes should give more attention to having technical equipment.

MoPH diagnosis services general in-charge, Ashiqullah Saadati, said they continuously monitored labs and diagnosis centres. He also didn’t deny the issues.

He said MoPH had created a law for operation and activity of private sector institutes and the law was being persistently enforced by the Observation and Investigation Department of the ministry.

Saadati said some labs had hired university students who possessed no work permit from the MoPH. “In 1394 solar year, we studied 55 hospitals in Kabul and provinces. Of them, 28 hospitals having low quality were recommended to be standardized and nine others were closed down.”

“A private hospital that used using low quality ‘reagent’ was shut down by MoPH.” He said the ministry was mulling over the closure of laboratories not up to standard.

He also acknowledged illegal use of others’ work permits by laboratories, saying such act challenged the accuracy and reliability of diagnosis results and professionalism of lab workers.

He said the Observation and Investigation Department was considering a long-term monitoring policy for private laboratories and work permits of substandard labs would be cancelled.

A recent survey by the Integrity Watch Afghanistan (IWA) last week showed despite spending hundreds of millions of dollars by the donor community on Afghanistan’s public health sector, these facilities across the country face major deficiencies, including poor management, corruption, lack of power and potable water.

IWA inspected 184 public clinics and hospitals in eight provinces built or operated with donor money.

Four out of 10 health facilities lacked potable water system while one in every five facilities had no electricity at all. It claimed two-thirds of the health facilities did not have ambulances, adding to difficulties in accessing clinics and hospitals.

In spite of spending hundreds of millions of dollars of foreign aid on private public health sector, still issues existed, including lack of maintenance, inaccessible medical staff, lack of female health-care staff, and poor management and others.

However, MoPH’s plan and police director, Dr. Abdul Qadeer Qadeer, said the public health minister and his working team were seriously observing all the sectors of MoPH and there was zero tolerance for administrative corruption.